LSMA Management, Inc. · 2 days ago
Customer Service Manager
San Bernardino, CA
Full-time
Onsite
Mid, Senior Level
3+ years expLSMA Management, Inc. is seeking a Customer Service Manager to oversee the daily operations of their Customer Service and Call Center department. This role is responsible for ensuring service excellence across various health plans and leading a team to improve customer satisfaction and operational efficiency.
Government Administration
Responsibilities
Lead, coach, and manage the daily operations of the Customer Service team to ensure timely and accurate responses to member, provider, and health plan inquiries
Monitor call center metrics (AHT, ASA, FCR, abandonment rate, service level performance) to ensure compliance with internal expectations and contractual obligations
Serve as an escalation resource for complex cases, coordinating resolutions with Claims, Utilization Management, Credentialing, Contracting, IT, and Quality departments
Develop, maintain, and enforce policies and procedures related to customer service workflows in alignment with DHCS, CMS, DMHC, NCQA, HIPAA, and health plan requirements
Analyze trends and recurring issues to identify root causes, recommend operational improvements, and implement corrective action plans
Oversee documentation of all interactions in customer service platforms (e.g., EZ-Cap, Salesforce, CRM systems) ensuring accuracy, timeliness, and reporting readiness
Prepare reports, summaries, audit documentation, call logs, and dashboards for internal leadership and contracted health plans
Coordinate new hire training, ongoing staff development, competency validation, and regulatory education
Maintain and optimize call center tools, including IVR functionality, call routing systems, and case management databases
Support implementation of new lines of business, benefit updates, provider network expansions, contract changes, and system upgrades
Foster a culture of service excellence, teamwork, compliance, and professionalism across the department
Qualification
Required
Bachelor's degree in Business Administration, Healthcare Management, Public Health, or related field
3–5 years of progressive customer service or call center leadership experience within managed care, MSO, IPA, health plan, or healthcare operations setting
Demonstrated experience with call center technologies, telephony systems, and member/provider management systems (e.g., EZ-Cap, Salesforce, or comparable CRM)
Strong leadership, coaching, and team-building skills
High proficiency in call center operations, reporting, and CRM systems
Excellent written and verbal communication skills
Strong problem-solving and conflict resolution skills
Advanced data analysis and reporting skills in Excel or BI tools
In-depth understanding of managed care operations, including benefits, authorizations, claims, and provider network structures
Strong working knowledge of managed care programs (Medi-Cal, Medicare Advantage, Commercial HMO/PPO)
Knowledge of regulatory frameworks (CMS, DHCS, DMHC, NCQA) and health plan contract requirements
Comprehensive understanding of CMS, DHCS, DMHC, NCQA, and HIPAA regulatory requirements
Proven ability to interpret data, identify trends, and implement strategies to improve service performance and customer satisfaction
Familiarity with HIPAA privacy and security rules and customer service documentation standards
Ability to manage competing priorities and meet deadlines in a fast-paced environment
Ability to build productive relationships with internal teams and external partners
Ability to communicate complex information clearly to providers, members, staff, and leadership
Ability to implement process improvements and drive department-wide performance
Ability to maintain confidentiality, professionalism, and compliance at all times
Preferred
Experience supporting or participating in delegation oversight, external audits, and health plan reporting requirements
Experience leading onsite, hybrid, or remote customer service teams
Previous managed care project leadership experience (implementations, benefit changes, system enhancements)
Bilingual in English/Spanish skills preferred
Company
LSMA Management, Inc.
We’ve seen the stress and toll that poor management takes on practices: the rigid policies, the pressure to prioritize volume over patient relationships and clinical judgment, the operational breakdowns that erode trust.
501-1000 employees
Funding
Current Stage
Late StageCompany data provided by crunchbase